Eating Disorders Awareness Week

Anorexia nervosa and bulimia nervosa kill an estimated 1,000 to 1,500 Canadians per year. These deaths are often the result of life-threatening medical complications, and suicide among people with eating disorders. Death certificates often do not record eating disorders as the cause of death, thus hiding the true lethality of eating disorders. In fact, eating disorders have the highest mortality rate of any mental illness.

This is Eating Disorders Awareness Week, an annual campaign that runs from February 1st through 7th to raise awareness and understanding of eating disorders. A host of awareness events and activities are scheduled across the province throughout the week.

What Are Eating Disorders?

Eating disorders are characterized by severely disturbed eating behaviours. They typically begin in adolescence or young adulthood and affect women ten times more than men. The National Eating Disorder Information Centre describes eating disorders as “a serious brain disease, with complex roots that manifest themselves through unhealthy eating behaviours.” There are several types and subtypes of eating disorders, including:

Causes of Eating Disorders

Many factors can contribute to eating disorders. Issues like low self-esteem, perfectionism, impulsive behaviour, and troubled relationships can all be contributors.

Peer pressure, media images and social practices can also contribute. Peer pressure and media may fuel the desire to be thin, particularly among young girls; expectations about body image are reinforced by a societal bias of thinness as being desirable.

Some people may actually be more genetically prone to developing eating disorders than others. In its report Eating Disorders Among Girls And Women In Canada, the Parliamentary Standing Committee on the Status of Women heard that the heritability for anorexia nervosa is about 75% — higher than many illnesses commonly understood to be genetically determined, such as schizophrenia (with a heritability of about 50%) and type II diabetes (about 70%). Bulimia nervosa is also believed to have a strong genetic basis. The genetic predisposition of certain individuals to eating disorders was described to the Committee as a “ticking time bomb,” waiting to be triggered by any of a complex array of social, cultural, and environmental factors.

Our Relationship with Food

Our attitudes and behaviours around food are often tied to mood, body image, and even self-esteem. The website Jessie’s Legacy talks of “disordered eating” — a spectrum of behaviours about food and body image. At one end we have healthy/normal eating habits with body acceptance, and at the other we have eating disorders such as anorexia, bulimia, or binge eating disorder. These behaviours are related to body image, and are not necessarily just about eating. They include weight/shape preoccupation; excessive exercising, fasting or food restriction; compulsive overeating; purging; steroid use; and laxative abuse.

Sometimes these behaviours arise in our lives due to stress, illness, or in anticipation of a big event such as a sports tournament, graduation, or a wedding. However, when disordered eating continues for prolonged periods of time and starts to interfere with our everyday lives, or we find ourselves using it to cope with stress and emotions, it may lead to an eating disorder. Those “dabbling” in disordered eating are more at risk for eating disorders.

Eating Disorders are generally believed to be a young woman’s disease. But they can affects girls as young as five years old, women over 60 who have been living with the disease for decades, and boys and men. The US National Eating Disorders Association reports that males represent 25% of individuals with anorexia nervosa and bulimia nervosa, and 36% of those with binge eating disorder.

There’s an underlying message in our culture that being thin equals happiness, perfection, and being in control. The perpetuation of this notion can lead to many children and teens developing an unhealthy body image, and engaging in unhealthy behaviour to achieve it.

According to jessieslegacy.com, almost all women and girls over the age of eleven have at one time indulged in disordered eating. Research says that 81% of 10-year-olds are afraid of being fat, and 98% of females are unhappy with their bodies.

According to the American Journal of Psychiatry, eating disorders have the highest mortality rate of any mental disease: they are 12 times more likely to lead to death than any other mental illness.

The National Association of Anorexia Nervosa and Associated Disorders in the USA reported that 5–10% of anorexics die within 10 years after contracting the disease; 18-20% die after 20 years and only 30-40% ever fully recover.

Data provided to the Standing Committee on the Status of Women for their Report on Eating Disorders Among Girls and Women in Canada (released November 2014) suggest that as many as 600,000 to 900,000 Canadians meet the diagnostic criteria for an eating disorder at any given time.

Statistics Canada data suggests that the rate of obesity in adolescent girls in Canada is 9%. The rate of eating disorders among the same population is estimated to be around 18%.

Many eating disorder sufferers have a myriad of personality issues, developmental concerns, psychological distresses, and psychiatric problems. The incidence of sexual abuse or significant traumatic experience in individuals with eating disorders is over 66%.

About one-tenth of the population is thought to be living with an eating disorder. The numbers are greater among dancers, models, actors, and athletes.

Warning Signs

Changes in behaviour often accompany an eating disorder. These changes can serve as warning signs of an eating disorder. But, because the person with an eating disorder may also experiences shame or guilt about their behaviour, they may try to hide it. Because of this, the warning signs can be difficult to detect. Following are some warning signs suggested by the Australian Eating Disorders Victoria. Bear in mind that it is possible that a person may demonstrate many of these signs, and yet not have an eating disorder. It is always best to get a professional opinion.

Deceptive behaviour around food, such as secretly throwing food out, eating in secret or lying about amount or type of food eaten

Change in clothing style, such as wearing baggy clothes

Continual denial of hunger

Physical Warning Signs

Sudden or rapid weight loss

Frequent changes in weight

Feeling cold most of the time, even in warm environments

Loss or disturbance of menstrual periods (in females)

Signs of frequent vomiting – swollen cheeks or jawline, calluses on knuckles, or damage to teeth

Fainting, dizziness, and fatigue

Psychological Warning Signs

Increased preoccupation with body shape, weight and appearance

Intense fear of gaining weight

Constant preoccupation with food or with activities relating to food

Extreme body dissatisfaction or distorted body image (complaining of being fat when they are actually at a healthy weight or underweight)

Heightened anxiety around meal times

Depression, anxiety, or irritability

Low self-esteem; feeling worthless, ashamed, guilty, or self-loathing

Feelings of life being out of control

Feelings of being unable to control behaviours around food

Much of this stems from unrealistic expectations around body type. We can challenge the biases and attitudes around thinness and unhealthy weight loss, and counter the belief that a certain body size will lead to happiness and fulfillment. Instead we should encourage healthy eating habits, promote a healthy body image, and analyze and discuss media messages. Eating Disorder Awareness Week provides opportunities to discus and learn more about this troubling condition.

Eating Disorders Awareness Week

If you suspect that someone close to you has an eating disorder, seek professional help. You can find resources around eating disorders by texting the name of your community to 2-1-1 between 8 am to 11 pm. You can also dial 2-1-1 or email help@bc211.ca anytime of the day. This is a free service. You can also visit The Red Book Online, bc211’s online directory of resources.